Need help, production numbers

[JulzBee]

Hello, I'm a Derm PA straight from PA school with about 19 months experience on hand in the greater SF Bay area, California region. My supervising MD wants to switch me over from base pay with benefits to a production base pay schedule. I have no idea what to expect and what percentage is reasonable. Should I also be expecting benefits like CME, vacation days, holiday and such? Any advice or knowledge you can share would be greatly appreciated!

[Bird303]

If you are working straight production, then any vacation day is a day that you are not collecting revenue for the practice and therefore ultimately decreasing your take home amount. Tell us a little more information about your current arrangement so we can see where this may be headed. What is your current base salary? What are your approximate collections for the past 12 months (If you don't know them, then is the MD willing to show you this information?)? Do you have a stable patient base? After only 19 months, you may not have a stable and full enough schedule to make sense of a 100% production based compensation structure. These are important numbers to know so that you can have some idea as to what you may earn in a year, based on what % is agreed upon. I have read anywhere between 30-45% of collections, but maybe someone else will chime in to confirm these numbers. Did your supervising MD propose a % yet? Are there any other PAs at the practice with this structure that you could ask? Give us some more information and we will be able to answer your questions more accurately.  

[JulzBee]

That's the problem.  He used to give me monthly reports on my production and that stopped.  There used to be two PAs but one left; we're both hired on as new grads.  Initially, he said i will not be switched over until i've had 3 years experience.  I don't know what changed his mind.  He's tried switching me over at 1 year and i said no.  The last number he threw at me was 22% which, even as a newbie, sounds very low.

 

I've inquired about doing cosmetics and surgery which he continues to say i am not ready, understandable in some ways.  I see pts on my own anywhere from 15-25/day which is not consistent yet.  My base pay is not great but decent at 90K/year but includes most benefits including health, CME, vacation, holiday and sick pay but with an unrealistic bonus agreement.  I've stuck around and declined higher pay offers in other specialty because i do enjoy derm and its lifestyle.  I've recently became a medicare provider and he insists that my schedule will become full so production would be the way to go for me.  I don't know anyone else in derm or anyone with that compensation so desperately need help.  He wants to switch me over in June but i want to do some research going in rather than accepting what sounds reasonable.  

[coloradopa]

That's the problem.  He used to give me monthly reports on my production and that stopped.  There used to be two PAs but one left; we're both hired on as new grads.  Initially, he said i will not be switched over until i've had 3 years experience.  I don't know what changed his mind.  He's tried switching me over at 1 year and i said no.  The last number he threw at me was 22% which, even as a newbie, sounds very low.

 

I've inquired about doing cosmetics and surgery which he continues to say i am not ready, understandable in some ways.  I see pts on my own anywhere from 15-25/day which is not consistent yet.  My base pay is not great but decent at 90K/year but includes most benefits including health, CME, vacation, holiday and sick pay but with an unrealistic bonus agreement.  I've stuck around and declined higher pay offers in other specialty because i do enjoy derm and its lifestyle.  I've recently became a medicare provider and he insists that my schedule will become full so production would be the way to go for me.  I don't know anyone else in derm or anyone with that compensation so desperately need help.  He wants to switch me over in June but i want to do some research going in rather than accepting what sounds reasonable.  

I'll post the take home points from Trish Marriott on the talk on PA productivity that she gave last year. Basically just say no (and get an AAPA salary report since you seem on the low end). 

 

Calculating PA Productivity requires in-depth knowledge of billing and reimbursement policy and claims methodology for the various payers.

•Many claims are submitted under the physician’s identification number (NPI), rendering the PA’s work invisible in the claims data.

•Unless a PA’s work (production) and financial contribution can be fully attributed to the PA, a production based compensation formula is not calculable and should not be negotiated.

[Purrpa]

Are you a member of the Society of Dermatology PAs? dermpa.org When I worked in derm I found this organization to be extremely helpful in similar matters. IMO the the members of this organization are some of the most supportive & helpful group of PAs I've seen in > 20 yrs as a PA. Here is a sample article...(btw, you can google the author & connect w her on LI or via her website)

http://www.dermpa.org/PDF/Dermatologists/Contracting-with-PAs-and-NPs-15-Tips-for-Mutual-Satisfaction.pdf

 

 

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[olsambo]

I just started working in Derm at a base of 96k and my bonus structure is terrible compared to the national average. 22% is too low, you should look at 35%. The doc I work for is very open with me and supportive that I should make what he makes in terms of production percentages. Unfortunately, we work for a multi specialty clinic that requires the share holders to vote and support what we consider to be an appropriate model. With that said, the Dermatologist is going to bat for me by providing me with opportunities to bill for all the procedures, and to even taking his that he isn't too interested in doing. He is also  getting me involved with heading research and other opportunities to diversify my income and bonus streams.

 

The reason for telling you this, there are some people who value people and talent and recognize that if they help you grow, you will help them grow their practice. If I were you, I would consider looking for such a doctor/practice. In such a setting, you can truly thrive.